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Organization

THE FOOT AND ANKLE CLINIC OF WEST MONROE, LLC

Active
Other names
The Foot and Ankle Clinics
Organization subpart
No

Provider details

NPI number
Authorized official
TAYLOR RECORD CCMA (CREDENTIALING COORDINATOR)
(318) 397-1574
Entity
Organization

Contact information

Practice address
2309 ARKANSAS RD, WEST MONROE, LA 71291-7820
(318) 397-1574
(318) 397-1672
Mailing address
3601 DESIARD ST, MONROE, LA 71203-4352
(318) 397-1574
(318) 397-1672

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
363L00000X
Nurse Practitioner
363LA2100X
Acute Care Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2372726
LA
Enumeration date
05/07/2024
Last updated
05/07/2024
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